Community policing is defined as the establishment and use of partnerships and problem-solving techniques to address public safety concerns, such as the rise of crime in a particular geographic area. Over the decades, policing in the United States has changed from a two-pronged system with a volunteer patrol and a pay-per-warrant force to a unified police force. By the 1880s, all states had a unified police force, with the primary goal of disorder control rather than preventing an increase in crime. Throughout the history of policing in the United States, the role of police officers, in its fundamental form, has remained the same: protect their community. However, how this is done today looks very different than it did in the 1880s.
Since the 1950s and 1960s, due to a variety of reasons—such as Social Security and other governmental benefits, advances in treatments, a greater awareness of the substandard conditions of state psychiatric hospitals, and the emerging civil rights movement—deinstitutionalization of individuals with serious mental illnesses began to occur. However, many communities lacked the social services to assist those with mental health concerns. As a result, modern police forces often are called upon to interact with and assist persons with serious mental illnesses, despite having little training.
This article focuses on community policing and the Crisis Intervention Team (CIT) model, a model that the CIT International organization defines as a specialized police-based crisis response model, integrating community, mental health care, and mental health advocacy groups. The training that CIT provides (which can be started independently by any agency) gives law enforcement and other first responders the knowledge and skills to respond to calls involving persons with mental illnesses, while maintaining the safety of all parties involved. This training strives to reduce stigma and keep persons with mental illnesses out of the justice system when possible, coupled with innovative problem-solving and program development.
Community Policing Overview
According to the U.S. Department of Justice, community policing is built upon three components: community partnerships, organizational transformation, and problem-solving. Community partnerships may involve other government institutions, local nonprofit organizations, community businesses, and the media. Organizational transformation refers to the administrative aspect, such as agency management (e.g., culture, leadership), organizational structure (e.g., geographic placement of law enforcement officers), personnel (e.g., hiring practices), and information systems (e.g., communications, data access and use). Problem-solving follows the acronym SARA: scanning (e.g., identifying problems), analysis (e.g., research), response (e.g., long-lasting solution development), and assessment (e.g., evaluation of the response).
One model that was initially hailed as the gold standard of policing, and may have served as a predecessor to community policing, is known as the broken windows theory. A criminological theory first detailed in 1982 by James Q. Wilson and George L. Kelling, the broken windows theory suggested that law enforcement focus on lesser or misdemeanor crimes (e.g., broken windows) as a way to prevent more serious crimes (e.g., homicide). As a result, communities would feel comfortable, safe, and empowered, thereby reducing the amount of criminal activity.
Broken windows was introduced in New York City by Rudy Giuliani, who took office as mayor in 1993, and his police commissioner, William Bratton. Very quickly, the city saw a sharp decrease in criminal activity, and broken windows was hailed by some as a miracle. However, skepticism also arose. Columbia Law School professor Bernard Harcourt noticed that crime was decreasing not only in New York City but also across the entire country where broken windows was not implemented. Moreover, crime decreased in cities with rampant police corruption, such as Los Angeles. In an attempt to explain why broken windows was not as effective as it seemed, Harcourt referred to regression to the mean; in other words, what goes up must come down. Before the sharp downtick in criminal activity was a pattern of upticks and downticks in the same behavior. While Kelling acknowledges broken windows may not be the miracle everyone was looking for, he claims it still has value, stating that any reduction in crime is positive.
Broken windows was followed by another policing technique known as stop and frisk, whereby officers pull over or stop civilians and search them for weapons or other illegal items. After taking office as New York’s new mayor in 2001, Michael Bloomberg wanted to take broken windows one step further and prevent crime before it even happened, leading to the use of stop and frisk by New York City police officers. Of the 250,000 stops made by the New York City Police Department in 2008, only one fifteenth of 1% revealed a gun. Moreover, because African American citizens were the ones in neighborhoods with more physical broken windows, loitering, and graffiti, arrests of African Americans increased. In 2013, a federal district court ruled stop and frisk unconstitutional, and then-Mayor Bill DeBlasio officially ended the practice but reinstated both broken windows and Giuliani’s police commissioner Bill Bratton.
Despite evidence showing broken windows does not work, Harcourt says it maintains popularity because it is an easy idea for the public and the government to understand. The balance of the popular versus the scientific is critical when discussing how police interact with persons with mental illnesses. In that regard, it is important to include CIT in a discussion of community policing, as the issue of how to resolve situations involving persons with mental illnesses and relationships between law enforcement and the mental health community involves systematic partnerships and collaboration in the same way that community policing does.
The Impact of Serious Mental Illnesses on Policing
To understand the role of CIT in the law enforcement community and in society at large, how mental illnesses factor into daily policing efforts needs to be understood. Mental health concerns are not isolated from the law enforcement community. According to the National Institute of Mental Health, approximately one in five adults (43.8 million or 18.5%) experience a mental illness in any given year, with one in 25 adults (10 million or 4.2%) experiencing a serious mental illness that impairs daily functioning. Many individuals with mental health concerns also abuse substances, making the job more challenging for the responding officer. Issues arise as to the legality of the person’s actions: Is the person committing a crime, or is he or she acting due to the symptoms of a psychological condition? Because law enforcement officers are trained to recognize crime rather than psychological distress, the effects of the mental health condition may go unrecognized or be downgraded in favor of immediate community safety. The outcomes of such a decision may end well, but they are just as likely to end poorly.
Many police officers cite interactions with persons with mental illnesses as a significant concern. Estimates of police interactions with persons with mental illnesses range from 7% to 49% of all encounters. Feelings of preparedness among officers and their colleagues tend to be mixed, with about a 50/50 split of each according to one published study. International research documents the problem, with one major study conducted by the Mental Health Commission of Canada finding that persons with mental illnesses had 3.1 times more interactions with police compared to the general public, were twice as likely to be reinvolved with the police compared to the general public (79.9% vs. 38.3%), and were more likely to be convicted of an offense compared to a member of the general public who committed the same offense but does not have a mental illness (72% vs. 60%). As such, many persons with mental illness tend to be housed in the justice system rather than receiving proper psychiatric care, with a 2006 special report by the Bureau of Justice Statistics estimating a total of 705,600 persons with mental illnesses housed in state prisons, 78,800 in federal prisons, and 479,000 in local jails.
Despite recent media reports and cellphone videos posted online to video-sharing sites such as YouTube, interactions between police and persons with mental illnesses rarely lead to fatalities. Nonetheless, use of force tends to be more frequent against persons with mental illnesses compared to members of the general public. Despite mental health–related legislation and policies in every U.S. state and Canadian province, police frequently report feeling trapped regarding how to handle the situation due to their own stress, lack of resources such as hospital beds, and pressure from supervisors to move on to the next call. As a result, police tend to express frustrations with the mental health system, and the mental health system tends to feel frustrated with law enforcement. Thus, specialized training and forms of collaboration, such as CIT, have been developed.
CIT Model
Development
CIT, also known as the Memphis Model, was developed in Memphis, TN, in 1988, after law enforcement officers fatally shot an individual with a mental illness. Since its inception, CIT has been implemented in multiple jurisdictions in nearly all states in the United States, with Canada, Australia, and New Zealand using similar models (e.g., Toronto’s Mental CIT that pairs a trained law enforcement officer with a registered nurse; New South Wales’ Mental Health Intervention Team).
Core Elements
CIT International divides the core elements of CIT into three types: ongoing, operational, and sustaining. Ongoing elements constitute partnerships between law enforcement, advocacy groups (e.g., National Alliance on Mental Illness, Mental Health America), and mental health services and organizations. Operational elements are the roles of officers, dispatchers, and coordinators; curriculum development; and mental health facilities, such as emergency services. Finally, sustaining elements include evaluation and research, in-service training, recognition and honors, and outreach (developing CIT in other communities; local, regional, and statewide implementation; and legislative change).
Curriculum
CIT International states that a successful implementation of the training for most jurisdictions will have trained approximately 20–25% of the agency’s patrol division, with consideration of various factors such as agency location, size, and resource access. CIT officers typically volunteer for the 40-hr comprehensive training. CIT programs often divide their training into five activities: (1) didactics and lectures to convey specialized knowledge (e.g., clinical issues, medications, co-occurring disorders, suicide prevention), (2) on-site visits and exposure to persons with mental illnesses who are in successful treatment and recovery, (3) practical skill development through scenario-based training, (4) questions and answers, and (5) commencement and recognition. Dispatchers are also encouraged to receive some version of CIT training. Their curriculum is comprised of four elements: (1) recognition and assessment of a crisis event, (2) appropriate questions to ask a caller, (3) how to identify the nearest CIT officer, and (4) policies and procedures. While an approved CIT curriculum needs to adhere to these components, each community develops its curriculum based on local needs, political climate, and access to resources, among other factors.
Use of Force
Of great importance to police and persons with mental illnesses is use of force, that is, how much force is being used against a person with a mental illness by law enforcement to resolve the situation. While they still use force when appropriate, CIT-trained officers appear to use less force compared to their non-CIT-trained counterparts to resolve the same or similar calls, relying on other techniques such as verbal de-escalation.
Handcuffs are one use-of-force tool that is controversial within the mental health community. Many mental health advocates state that they should be avoided because they add to the embarrassment and perceived injustice of the individual. Moreover, handcuffs can make the individual feel like a criminal, even though mental health concerns are not a criminal act. Seeing a person with mental illness in handcuffs runs counter to efforts to dissociate mental health problems from criminal activity. However, law enforcement officers are often instructed to exercise discretion, thereby allowing them to decide when handcuffs should be used. The ideal goal is to use them only when the individual is combative and jeopardizes his or her own safety or the officer’s or others’ safety.
CIT training educates officers as to when a situation may call for the use of an assistive device (e.g., handcuffs), while allowing officers to escort the individual to a hospital or other mental health services, either via patrol car or ambulance. The implementation of state or provincial mental health law–related policies also allows officers to take the person into custody for their own safety. CIT training teaches officers how to build relationships with their local hospitals and mental health facilities, while also educating them on what social services are available.
Empirical Evidence
CIT has been relatively extensively researched compared to other policing programs. To date, nearly all research in books and academic journals has focused on officer-level outcomes, that is, effectiveness of CIT training on improving their attitudes, knowledge, skills, and daily interactions with persons with mental illnesses. The majority of CIT research has demonstrated its effectiveness in allowing officers to recognize mental illnesses in others. CIT training may also be effective in allowing officers to recognize symptoms of mental illness in themselves (e.g., depression, anxiety, post-traumatic stress disorder, substance abuse) and to better understand what they are experiencing and thus seek the proper resources for treatment when needed. Moreover, CIT training helps officers to feel more confident in their department as well as in themselves to handle calls involving persons with mental illnesses. Finally, while CIT training can be expensive, it is cost-efficient in the long term. For example, a 2014 study found that the implementation of training in a medium-sized city cost USD $2,430,128, with annual savings post-training of USD $3,455,025.
References:
- Brink, J., Livingston, J., Desmarais, S., Greaves, C., Maxwell, V., Michalak, E., . . . Weaver, C. (2011). A study of how people with mental illness perceive and interact with the police. Calgary, Canada: Mental Health Commission of Canada. Retrieved from http:// www.mentalhealthcommission.ca
- Compton, M. T., Bakeman, R., Broussard, B., Hankerson-Dyson, D., Husbands, L., Krishan, S., . . . Watson, A. C. (2014). The police-based Crisis Intervention Team (CIT) model: I. Effects on officers’ knowledge, attitudes, and skills. Psychiatric Services, 65(4), 523–529. doi:10.1176/appi.ps.201300108
- Compton, M. T., Neubert Demir, B., Broussard, B., McGriff, J. A., Morgan, R., & Oliva, J. R. (2011). Use of force preferences and perceived effectiveness of actions among Crisis Intervention Team (CIT) police officers and non-CIT officers in an escalating psychiatric crisis involving a subject with schizophrenia. Schizophrenia Bulletin, 37(4), 737–745. doi:10.1093/schbul/sbp146
- El-Mallakh, P. L., Kiran, K., & El-Mallakh, R. S. (2014). Costs and savings associated with implementation of a police Crisis Intervention Team. Southern Medical Journal, 107(6), 391–395. doi:10.14423/01.SMJ.0000450721.14787.7d
- National Public Radio (NPR). (2016, November 1). How a theory of crime and policing was born, and went terribly wrong. Retrieved from http://www.npr.org/ 2016/11/01/500104506/broken-windows-policing- and-the-origins-of-stop-and-frisk-and-how-it-went-wrong
- S. Department of Justice. (2014). COPS: Community oriented policing. Retrieved from https://ric-zai-inc.com/Publications/cops-p157-pub.pdf